Despite treatment, HbA1c ≥ 37 mmol/mol in the first trimester is associated with premature delivery among South Asian women with gestational diabetes mellitus: a retrospective cohort study.

Autor: Punnose J; Department of Endocrinology and Metabolism, St. Stephen's Hospital, Tis Hazari, Delhi, 110054, India. drpunnose@rediffmail.com., Malhotra RK; Dr BRA IRCH, AIIMS, Delhi, India., Sukhija K; Department of Endocrinology and Metabolism, St. Stephen's Hospital, Tis Hazari, Delhi, 110054, India., Rijhwani RM; Department of Endocrinology and Metabolism, St. Stephen's Hospital, Tis Hazari, Delhi, 110054, India., Choudhary N; Department of Obstetrics and Gynecology, St. Stephen's Hospital, Delhi, India., Sharma A; Department of Obstetrics and Gynecology, St. Stephen's Hospital, Delhi, India.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2024 Aug; Vol. 310 (2), pp. 863-872. Date of Electronic Publication: 2024 Mar 22.
DOI: 10.1007/s00404-024-07422-4
Abstrakt: Purpose: To examine the effects of first-trimester HbA1c (HbA1c-FT) ≥ 37 mmol/mol on preterm birth (PTB) and large-for-gestational-age (LGA) babies in a retrospective cohort of South Asian pregnant women with gestational diabetes (GDM).
Methods: The cohort (n = 686) was separated into two groups based on HbA1c-FT values: Group A (n = 97) and Group B (n = 589), with values of 37-46 mmol/mol (5.5-6.4%) and < 37 mmol/mol (5.5%), respectively. HbA1c-FT's independent influence on PTB and LGA babies was examined using multivariable logistic regression in groups A and B women. The reference group (Group C) included 2031 non-GDM women with HbA1c-FT < 37 mmol/mol (< 5.5%). The effects of HbA1c-FT on PTB and LGA babies in obese women in Groups A, B, and C (designated as A-ob, B-ob, and C-ob, respectively) were re-analyzed using multivariable logistic regression.
Results: Group A GDM women with greater HbA1c-FT had a higher risk for PTB (aOR:1.86, 95% CI:1.10-3.14) but not LGA babies (aOR:1.13, 95%: 0.70-1.83). The risk of PTB was higher for obese women in Group A-ob: aOR 3.28 [95% CI 1.68-6.39]. However, GDM women with normal HbA1c-FT exhibited no elevated risk for PTB: Groups B and B-ob had aORs of 1.30 (95% CI 0.86-1.98) and 1.28 (95% CI 0.88-1.85) respectively.
Conclusions: South Asian GDM women with prediabetic HbA1c FT; 37-46 mmol/mol (5.5-6.4%) are more likely to deliver preterm babies despite treatment, while the risk for LGA babies was the same as non-GDM women.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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